| NPI | 1003818196 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: MD D58315) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: DC MD33236) |
| Enumeration Date | 2005-06-02 |
| Last Update Date | 2008-03-13 |