| NPI | 1700118528 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: OH 35.147452) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OH 35.147452) |
| 207Y00000X Otolaryngology (Licence: MD D85405) | |
| Enumeration Date | 2010-02-03 |
| Last Update Date | 2023-02-28 |