| NPI | 1386817484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: VA 0101256833) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: PA MD441203) |
| 207Y00000X Otolaryngology (Licence: TN MD49732) | |
| Enumeration Date | 2008-04-09 |
| Last Update Date | 2020-10-16 |