| NPI | 1720039449 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: PA MD048638L) |
| Additional Taxonomies | 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: PA MD048638L) |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2008-04-17 |