| NPI | 1861405706 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: DC MD32942) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: DC MD 32942) |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2023-03-31 |