| NPI | 1992781157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MO 1999140782) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: KS 04-26208) |
| Enumeration Date | 2005-12-20 |
| Last Update Date | 2010-02-08 |