| NPI | 1497911184 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: DC MD038620) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: IL 125047836) |
| 207Y00000X Otolaryngology (Licence: MA 238459) | |
| 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: MD D0070469) | |
| 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: VA 0101247020) | |
| Enumeration Date | 2008-08-01 |
| Last Update Date | 2012-03-02 |