| NPI | 1023038718 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: PA MD-031816-E) |
| Additional Taxonomies | 207YX0007X Otolaryngology Plastic Surgery within the Head & Neck (Licence: PA MD-031816-E) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2014-05-05 |