| NPI | 1255472197 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MD D0068707)  | 
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: DC MD048745)  | 
| Enumeration Date | 2007-02-12 | 
| Last Update Date | 2023-07-12 |