| NPI | 1740308907 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: CA A38298) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA A38298) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2010-06-18 |