| NPI | 1346325180 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: CA G54420) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA G83612) |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2019-09-16 |