| NPI | 1053577924 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: IL 036.144383) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: PA MT193950) |
| 207Y00000X Otolaryngology (Licence: NY 293812) | |
| 207Y00000X Otolaryngology (Licence: OH 35.120793) | |
| Enumeration Date | 2008-07-31 |
| Last Update Date | 2021-10-28 |