| NPI | 1740375245 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MD D31183) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: PA MD479530) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2025-05-15 |