| NPI | 1164422507 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: VA 0101051871) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: VA 0101051871) |
| 207Y00000X Otolaryngology (Licence: VA 0101051871) | |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2025-03-19 |