| NPI | 1154361624 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: SC 35106) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NC 9801299) |
| 207Y00000X Otolaryngology (Licence: SC 35106) | |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2016-03-10 |