| NPI | 1750336582 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: OH 35.120989) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: PA md424615) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2013-07-02 |