| NPI | 1821069626 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: FL ME63805) |
| Additional Taxonomies | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: CA G66336) |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2014-07-08 |