| NPI | 1043392376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: OH 34001547) |
| Additional Taxonomies | 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: OH 34001547) |
| 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: OH 34001547) | |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2007-07-08 |