| NPI | 1417183351 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: IA MD-41586) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: IA R-8678) |
| Enumeration Date | 2009-06-05 |
| Last Update Date | 2014-06-26 |