| NPI | 1457521544 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA A124730) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OH 35.095449) |
| Enumeration Date | 2008-03-05 |
| Last Update Date | 2021-09-01 |