| NPI | 1740481530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA 127942) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OH 57011560) |
| 207Y00000X Otolaryngology (Licence: MI 4301097625) | |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2014-11-25 |