| NPI | 1114965738 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NY 160661) |
| Additional Taxonomies | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: NY 160661) |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2010-06-24 |