| NPI | 1982767141 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: PA MD043027L) |
| Additional Taxonomies | 207YS0123X Otolaryngology Facial Plastic Surgery (Licence: PA MD043027L) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2007-12-08 |