| NPI | 1215911516 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0901X Otolaryngology Otology & Neurotology (Licence: LA 007896) |
| Additional Taxonomies | 207YX0901X Otolaryngology Otology & Neurotology (Licence: TN 3843) |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2014-03-13 |