| NPI | 1548527849 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: OH 35.131355) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OH 57.021125) |
| Enumeration Date | 2012-04-12 |
| Last Update Date | 2022-07-21 |