| NPI | 1356470678 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: DC MD038546) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A83922) |
| 174400000X Specialist (Licence: VA 0101249538) | |
| Enumeration Date | 2007-03-04 |
| Last Update Date | 2018-04-05 |