| NPI | 1962626671 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MI 4301087787) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: PA MD422413) |
| 207YX0901X Otolaryngology, Otology & Neurotology (Licence: MI 4301087787) | |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2019-10-30 |