| NPI | 1013967371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: OH 35.061525) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OH 35061525C) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2022-03-21 |