| NPI | 1225036270 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: PA MD046736L) |
| Additional Taxonomies | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: PA MD046736L) |
| 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: PA MD046736L) | |
| Enumeration Date | 2005-07-13 |
| Last Update Date | 2025-01-30 |