| NPI | 1366452054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: OR MD25584) |
| Additional Taxonomies | 207YS0012X Otolaryngology Sleep Medicine (Licence: OR MD25584) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2016-04-08 |