| NPI | 1386734317 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: DE C10008212) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: PA MD061646L) |
| 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: DE C10008212) | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2012-01-04 |