| NPI | 1316070717 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MD D71707) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NC 2014-00330) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2021-12-08 |