| NPI | 1306897285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: OH 35084082) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OH 35084082F) |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2014-10-31 |