| NPI | 1316107055 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: PA MD449906) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: KY 47750) |
| Enumeration Date | 2008-06-16 |
| Last Update Date | 2016-10-05 |