| NPI | 1639196454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: PA MD459747) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: ND 9048) |
| 207Y00000X Otolaryngology (Licence: AZ 36942) | |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2016-12-07 |