| NPI | 1851360879 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WV 18975) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OH 35062604J) |
| 207Y00000X Otolaryngology (Licence: KY 33120) | |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2016-10-11 |