| NPI | 1083828495 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NY 260623) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: PA MT188339) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2021-09-02 |