| NPI | 1639505696 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: OH 35.148089) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MD D90529) |
| Enumeration Date | 2013-09-23 |
| Last Update Date | 2023-05-16 |