| NPI | 1396132478 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: PA MD473573) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: GA 85498) |
| 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: NJ 25MA11149200) | |
| Enumeration Date | 2015-04-16 |
| Last Update Date | 2021-08-04 |