| NPI | 1821434911 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0012X (Licence: GA 88640) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: PA MD458459) |
| 207Y00000X Otolaryngology (Licence: GA 88640) | |
| 207YS0012X (Licence: PA MD458459) | |
| Enumeration Date | 2013-05-15 |
| Last Update Date | 2023-10-27 |