| NPI | 1124137369 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: PA MD024840E) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD024840E) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2015-04-06 |