| NPI | 1164534343 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MA 220281) |
| Additional Taxonomies | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: PA MD450439) |
| 207YX0901X Otolaryngology, Otology & Neurotology (Licence: MA 220281) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2015-09-18 |