| NPI | 1699822536 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: PA MD445760) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NY 247362) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2018-12-31 |