| NPI | 1427037985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: PA MD 054975L) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MD D0041833) |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2022-01-28 |