| NPI | 1801813886 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: OH 094681) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MO 2003012210) |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2023-04-12 |