| NPI | 1184678856 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: VA 0101230426) |
| Additional Taxonomies | 207YX0602X Otolaryngology Otolaryngic Allergy (Licence: VA 0101230426) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2021-05-10 |