| NPI | 1215939863 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: WV 9727) |
| Additional Taxonomies | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: KY 21910) |
| Enumeration Date | 2005-08-12 |
| Last Update Date | 2011-03-15 |