| NPI | 1265439301 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WV 10220) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OH 35035903I) |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2013-08-09 |