| NPI | 1174985915 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: RI MD18494) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: RI MD18494) |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2022-05-31 |