| NPI | 1285724146 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: WA MD00016657) | 
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: WA MD00016657) | 
| Enumeration Date | 2006-10-13 | 
| Last Update Date | 2017-11-08 |