| NPI | 1225392558 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MD D85672) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: SC 40837) |
| 207Y00000X Otolaryngology (Licence: PA MT202290) | |
| Enumeration Date | 2012-07-02 |
| Last Update Date | 2019-03-23 |