| NPI | 1700851615 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MS 13734) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: MS 13734) |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2007-07-08 |