| NPI | 1912098039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: PA MD426647) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: LA MD024828) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2014-01-24 |