| NPI | 1164481727 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NC 94-00056) |
| Additional Taxonomies | 207YX0602X Otolaryngology Otolaryngic Allergy (Licence: NC 94-00056) |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2014-03-12 |