| NPI | 1942543111 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CT 62391) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NY FC4748945) |
| 207Y00000X Otolaryngology (Licence: AL MD.36891) | |
| Enumeration Date | 2013-04-05 |
| Last Update Date | 2019-07-19 |