| NPI | 1164803847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MA 269455) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MD P31391) |
| Enumeration Date | 2015-06-18 |
| Last Update Date | 2016-11-24 |