| NPI | 1679577571 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: TX G5879) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: GA 018886) |
| Enumeration Date | 2005-06-08 |
| Last Update Date | 2008-02-06 |