| NPI | 1295771582 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: KY 47589) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OH 35084750) |
| 207Y00000X Otolaryngology (Licence: MO 2020038084) | |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2024-06-18 |