| NPI | 1235366196 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: PA MD445931) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA A107926) |
| Enumeration Date | 2009-06-18 |
| Last Update Date | 2012-06-08 |