| NPI | 1205148707 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MD D0079238) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OH ac2895437l2) |
| Enumeration Date | 2010-07-13 |
| Last Update Date | 2016-12-22 |