| NPI | 1518927409 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: PA MD057543L) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NY MD 234981) |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2020-08-30 |