| NPI | 1528445251 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: OH 35.125468) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OH 125468) |
| Enumeration Date | 2015-05-01 |
| Last Update Date | 2016-02-12 |