| NPI | 1518051036 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: PA MD062010L) |
| Additional Taxonomies | 207YP0228X Otolaryngology Pediatric Otolaryngology (Licence: PA MD062010L) |
| 207YX0007X Otolaryngology Plastic Surgery within the Head & Neck (Licence: PA MD062010L) | |
| 207YX0901X Otolaryngology Otology & Neurotology (Licence: PA MD062010L) | |
| 207YX0905X Otolaryngology Otolaryngology/Facial Plastic Surgery (Licence: PA MD062010L) | |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2024-03-11 |