| NPI | 1861524613 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX N2947) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: PA MD 433840) |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2022-12-16 |