| NPI | 1750397824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: AR E-15148) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OH 35-094159) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2023-05-04 |