| NPI | 1134169956 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: OH 35087530) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35087530) |
| 207Y00000X Otolaryngology (Licence: OH 35087530) | |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2022-09-06 |