| NPI | 1760643514 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YX0901X Otolaryngology Otology & Neurotology (Licence: CA A126098) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA 126098) |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2018-09-18 |