| NPI | 1063562544 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: VA 0101037612) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MD D0032351) |
| 207Y00000X Otolaryngology (Licence: DC MD14411) | |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2012-12-06 |