| NPI | 1023163706 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MD D0052876) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: DC MD18350) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2008-02-14 |