| NPI | 1194143107 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0901X Otolaryngology Otology & Neurotology (Licence: PA MD471799) |
| Additional Taxonomies | 207YX0901X Otolaryngology Otology & Neurotology (Licence: PA MT217507) |
| Enumeration Date | 2014-04-07 |
| Last Update Date | 2021-03-01 |