| NPI | 1184780108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: PA MD432401) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: PA MT186824) |
| 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: NY 256050) | |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2021-12-09 |