| NPI | 1679732796 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: PA MD440896) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NY 233530) |
| Enumeration Date | 2008-06-04 |
| Last Update Date | 2018-03-17 |