| NPI | 1013236819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: OH 35.133967) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OR MD181943) |
| 207Y00000X Otolaryngology (Licence: MD D74754) | |
| Enumeration Date | 2010-05-19 |
| Last Update Date | 2019-07-03 |