| NPI | 1861493819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: GA 33413) |
| Additional Taxonomies | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: LA 326023) |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2022-04-07 |