| NPI | 1053308098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: AZ MD22346) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: AZ 22346) |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2011-08-09 |