| NPI | 1942760392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WV 34110) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: PA MD484912) |
| Enumeration Date | 2019-03-21 |
| Last Update Date | 2024-07-24 |