| NPI | 1326013624 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: PA MD035385E) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: PA MD035385E) |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2021-04-15 |