| NPI | 1093756108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: OH 35138760) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: AL 26739) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2020-05-21 |