| NPI | 1699749002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MA 60000) |
| Additional Taxonomies | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: MA 60000) |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2008-07-02 |