| NPI | 1245523000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NY 308364) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: PA MD449343) |
| Enumeration Date | 2011-05-26 |
| Last Update Date | 2022-04-15 |