| NPI | 1932696200 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX U9903) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: PA MD480316) |
| Enumeration Date | 2018-04-21 |
| Last Update Date | 2024-05-14 |