| NPI | 1083753339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MD MD434613) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: PA MD434613) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2012-03-28 |