| NPI | 1548242100 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MD H0064647) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: PA OS-008770-L) |
| 207Y00000X Otolaryngology (Licence: VA 0102050002) | |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2012-10-24 |