| NPI | 1649271628 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: IA 21132) |
| Additional Taxonomies | 207YX0901X Otolaryngology Otology & Neurotology (Licence: SD 3906) |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2017-02-06 |