| NPI | 1063467447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: AL MD5034) |
| Additional Taxonomies | 261QS1200X Clinic/Center, Sleep Disorder Diagnostic (Licence: SC MD7394) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2010-10-06 |