| NPI | 1750584199 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: GA 95223) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: PA MD446675) |
| 207Y00000X Otolaryngology (Licence: MO 2020011596) | |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2023-08-15 |