| NPI | 1073700969 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: LA 331171) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: AZ R76064) |
| Enumeration Date | 2007-09-25 |
| Last Update Date | 2022-10-05 |