| NPI | 1174608053 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology Otolaryngology/Facial Plastic Surgery (Licence: VA 0101052066) |
| Additional Taxonomies | 207YP0228X Otolaryngology Pediatric Otolaryngology (Licence: VA 0101052066) |
| 207YX0602X Otolaryngology Otolaryngic Allergy (Licence: VA 0101052066) | |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2010-08-11 |