| NPI | 1780789164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WV 15615) |
| Additional Taxonomies | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: WV 15615) |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2007-07-08 |