| NPI | 1831191451 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WV 19758) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: KY 34885) |
| 207Y00000X Otolaryngology (Licence: OH 85091) | |
| Enumeration Date | 2005-08-12 |
| Last Update Date | 2021-11-17 |