| NPI | 1518008580 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: DC MD046548) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA A98600) |
| Enumeration Date | 2007-02-10 |
| Last Update Date | 2018-09-06 |