| NPI | 1700954526 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: OH 34002666) |
| Additional Taxonomies | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: OH 34002666) |
| 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: OH 34002666) | |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2008-03-19 |