| NPI | 1396001673 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: OH 35.130644) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OH 57.022088) |
| Enumeration Date | 2012-04-11 |
| Last Update Date | 2020-10-23 |