| NPI | 1932310224 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: OH 35093032) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MI 4301091474) |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2015-07-17 |