| NPI | 1104028638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MD D69675) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MA AM1208190-401) |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2013-01-05 |