| NPI | 1457612350 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MD D91088) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: DC MD049137) |
| 207Y00000X Otolaryngology (Licence: MN 67177) | |
| Enumeration Date | 2012-06-06 |
| Last Update Date | 2023-07-12 |