| NPI | 1386639466 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MD D0033303) |
| Additional Taxonomies | 174400000X Specialist (Licence: MD D0033303) |
| 207Y00000X Otolaryngology (Licence: MD d33303) | |
| Enumeration Date | 2005-09-15 |
| Last Update Date | 2011-09-12 |