| NPI | 1285628347 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YX0901X Otolaryngology Otology & Neurotology (Licence: OH 359069345) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: OH 35-069345) |
| Enumeration Date | 2005-09-06 |
| Last Update Date | 2011-06-09 |