| NPI | 1831728609 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: PA MD495777) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA A202388) |
| Enumeration Date | 2020-04-03 |
| Last Update Date | 2026-06-10 |