| NPI | 1942264171 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: PA MD009965E) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MI 4301093278) |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2023-03-07 |