| NPI | 1427059161 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: DC MD036979) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: VA 0101242497) |
| Enumeration Date | 2005-08-03 |
| Last Update Date | 2010-12-09 |