| NPI | 1003178617 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: PA MD472279) |
| Additional Taxonomies | 207YX0901X Otolaryngology Otology & Neurotology (Licence: TX BP10059932) |
| 207Y00000X Otolaryngology (Licence: HI MD17393) | |
| Enumeration Date | 2012-06-10 |
| Last Update Date | 2020-12-04 |