| NPI | 1487616074 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WV 23690) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: PA MD069097L) |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2022-04-12 |