| NPI | 1568558138 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: FL ME99151) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME99151) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2018-07-17 |