| NPI | 1619932514 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: PA MD018721E) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: PA MD018721E) |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2016-11-23 |