| NPI | 1114969185 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: OH 35084019) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35084019) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2021-02-09 |