| NPI | 1013984525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WV 19499) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OH 350788785) |
| 207Y00000X Otolaryngology (Licence: KY 37594) | |
| Enumeration Date | 2006-03-02 |
| Last Update Date | 2016-07-25 |