| NPI | 1194932921 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: DC MD041730) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA A108712) |
| 207Y00000X Otolaryngology (Licence: MD D0075914) | |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2017-02-02 |