| NPI | 1295930550 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: TX M7348) |
| Additional Taxonomies | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: CA A90039) |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2017-10-31 |