| NPI | 1982782942 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: KY 18612) |
| Additional Taxonomies | 207YP0228X Otolaryngology Pediatric Otolaryngology (Licence: KY 18612) |
| 207YX0602X Otolaryngology Otolaryngic Allergy (Licence: KY 18612) | |
| 207YX0901X Otolaryngology Otology & Neurotology (Licence: KY 18612) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2009-09-02 |