| NPI | 1295984953 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: PA MD463090) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA A103124) |
| 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: CT 50995) | |
| Enumeration Date | 2008-09-17 |
| Last Update Date | 2020-08-30 |