| NPI | 1588839153 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: LA MD202364) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA A102001) |
| 207Y00000X Otolaryngology (Licence: MD D66458) | |
| 207Y00000X Otolaryngology (Licence: NY 248340) | |
| Enumeration Date | 2008-04-24 |
| Last Update Date | 2011-11-17 |