| NPI | 1154641751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: VA 0101257743) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MD D79355) |
| Enumeration Date | 2010-06-04 |
| Last Update Date | 2015-06-23 |