| NPI | 1063657310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: PA MD464947) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MD D89638) |
| Enumeration Date | 2008-12-15 |
| Last Update Date | 2020-08-19 |