| NPI | 1932139227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: OH 35-07-5618-Z) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: WI 77128) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2024-03-21 |