| NPI | 1316327992 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WA OL61067988) |
| Additional Taxonomies | 207YX0901X Otolaryngology Otology & Neurotology (Licence: WA OL61067988) |
| Enumeration Date | 2015-06-09 |
| Last Update Date | 2020-07-20 |