| NPI | 1801802061 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: PA MD456768) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA G62618) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2020-08-31 |