| NPI | 1528563442 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WI 81319) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: PA MT216241) |
| Enumeration Date | 2018-03-25 |
| Last Update Date | 2023-10-06 |