| NPI | 1750322533 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: PA MD465358) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: KY 40581) |
| 207YX0901X Otolaryngology, Otology & Neurotology (Licence: KY 40581) | |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2020-08-28 |