| NPI | 1578545752 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: OH 34006187) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: KY 02420) |
| Enumeration Date | 2005-11-15 |
| Last Update Date | 2016-03-15 |