| NPI | 1811106008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: PA MD437820) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: PA MT190757) |
| 207Y00000X Otolaryngology (Licence: TN MD48340) | |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2022-07-21 |