| NPI | 1093716656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: RI MD4044) |
| Additional Taxonomies | 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: RI MD4044) |
| Enumeration Date | 2005-08-04 |
| Last Update Date | 2012-07-16 |