| NPI | 1104137454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: KY 47927) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MS T2320) |
| 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: KY 47927) | |
| 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: KY 47927) | |
| Enumeration Date | 2010-07-01 |
| Last Update Date | 2018-04-30 |