| NPI | 1295957702 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NV 12841) |
| Additional Taxonomies | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: NV 12841) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2015-04-15 |