| NPI | 1578527214 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX M8607) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OH 35078802C) |
| Enumeration Date | 2006-04-12 |
| Last Update Date | 2022-10-30 |