| NPI | 1285685966 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: PA MD066630L) |
| Additional Taxonomies | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: VT 042-0011660) |
| 207YX0901X Otolaryngology, Otology & Neurotology (Licence: AZ 53393) | |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2020-07-01 |