NPI | 1851580674 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: OH 35.121783) |
Additional Taxonomies | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: MI 4301102126) |
Enumeration Date | 2007-10-17 |
Last Update Date | 2014-01-22 |