| NPI | 1144230749 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CT 034314) | 
| Additional Taxonomies | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: CT 034314) | 
| 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: CT 034314) | |
| Enumeration Date | 2006-08-08 | 
| Last Update Date | 2009-07-02 |