| NPI | 1851393474 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: WV 18680) |
| Additional Taxonomies | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: KY 36609) |
| 207YX0901X Otolaryngology, Otology & Neurotology (Licence: OH 85251) | |
| Enumeration Date | 2005-08-12 |
| Last Update Date | 2021-05-07 |