| NPI | 1376814525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: CA A109584) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA A109584) |
| Enumeration Date | 2012-01-19 |
| Last Update Date | 2014-11-12 |