| NPI | 1154385805 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: OH 35.127231) |
| Additional Taxonomies | 174400000X Specialist (Licence: OH 35127231) |
| 207Y00000X Otolaryngology (Licence: IN 01075631A) | |
| 174400000X Specialist (Licence: MI MN053930) | |
| Enumeration Date | 2006-04-12 |
| Last Update Date | 2024-07-01 |