| NPI | 1407052236 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: AZ 58576) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA A116616) |
| 207Y00000X Otolaryngology (Licence: WV 23189) | |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2020-09-15 |