| NPI | 1255509626 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: OH 35.093839) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OH 35-093839) |
| Enumeration Date | 2008-02-19 |
| Last Update Date | 2020-12-13 |