| NPI | 1780615344 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MD D0059220) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: DC MD33525) |
| 207Y00000X Otolaryngology (Licence: VA 0101233279) | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2023-01-04 |