| NPI | 1821223942 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WI 84015-20) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: PA MD446831) |
| 207YX0901X Otolaryngology, Otology & Neurotology (Licence: PA MD446831) | |
| Enumeration Date | 2009-05-19 |
| Last Update Date | 2024-12-11 |