| NPI | 1376706762 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: KY 43990) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OH 35.092641) |
| Enumeration Date | 2008-07-07 |
| Last Update Date | 2012-03-15 |