| NPI | 1649253469 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: OH 35.053595) |
| Additional Taxonomies | 174400000X Specialist (Licence: OH 35053595) |
| Enumeration Date | 2005-11-25 |
| Last Update Date | 2015-06-30 |