| NPI | 1356332480 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MD HO0064011) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: PA OS-009417L) |
| Enumeration Date | 2005-10-28 |
| Last Update Date | 2008-03-12 |