| NPI | 1073991246 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: DC MD048112) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MD D0089351) |
| Enumeration Date | 2015-05-08 |
| Last Update Date | 2020-07-30 |