| NPI | 1134206881 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: KY 39335) |
| Additional Taxonomies | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: KY 39335) |
| 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: KY 39335) | |
| 207YX0901X Otolaryngology, Otology & Neurotology (Licence: KY 39335) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2018-05-01 |