| NPI | 1124538855 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: VT 042.0013821) |
| Additional Taxonomies | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: VT 042.0013821) |
| 207Y00000X Otolaryngology (Licence: NY 290092) | |
| 207YX0901X Otolaryngology, Otology & Neurotology (Licence: NY 290092) | |
| Enumeration Date | 2017-10-09 |
| Last Update Date | 2017-10-09 |