| NPI | 1164882460 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA F 428) |
| Additional Taxonomies | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: CA 2113 examption) |
| Enumeration Date | 2016-02-29 |
| Last Update Date | 2016-03-22 |