| NPI | 1871666099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: VA 0101039782) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: DC MD16366) |
| 207Y00000X Otolaryngology (Licence: MD D0033970) | |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2021-06-02 |