| NPI | 1588050017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CT 68113) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OR MD198371) |
| Enumeration Date | 2015-04-10 |
| Last Update Date | 2021-07-29 |