| NPI | 1669447447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: PA MD023068E) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NY 162219-1) |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2011-09-16 |