| NPI | 1326099508 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: OR MD2010-006) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NM MD2010-0006) |
| Enumeration Date | 2006-05-13 |
| Last Update Date | 2020-11-12 |