| NPI | 1720002132 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: OH 34.013866) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MI WR010496) |
| 207YX0901X Otolaryngology, Otology & Neurotology (Licence: MI 5101010496) | |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2023-03-06 |