| NPI | 1437449311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA A117437) |
| Additional Taxonomies | 207YP0228X Otolaryngology Pediatric Otolaryngology (Licence: CA A117437) |
| Enumeration Date | 2011-04-13 |
| Last Update Date | 2015-07-13 |