| NPI | 1609317874 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: PA MD481239) |
| Additional Taxonomies | 207YS0012X (Licence: PA MD481239) |
| Enumeration Date | 2017-03-20 |
| Last Update Date | 2024-02-04 |