| NPI | 1043358922 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: VA 01012340193) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: DC MD34115) |
| 207Y00000X Otolaryngology (Licence: MD D59857) | |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2007-07-08 |