| NPI | 1023227626 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NC 2019-00515) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: PA MT188734) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2021-04-28 |