| NPI | 1386008084 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MN 76746) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MI 4301507506) |
| 207Y00000X Otolaryngology (Licence: PA MD473590) | |
| Enumeration Date | 2016-04-08 |
| Last Update Date | 2024-04-15 |