| NPI | 1730125857 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: KY 49370) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MD D0038499) |
| 207Y00000X Otolaryngology (Licence: KY TP167) | |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2016-06-29 |