| NPI | 1154525012 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: WA MD60546639) |
| Additional Taxonomies | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: CO 50276) |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2015-05-05 |