| NPI | 1932127412 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: OR MD27634) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: IA 36708) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2011-01-25 |