| NPI | 1245260207 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: RI MD0004) |
| Additional Taxonomies | 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: PA MD053741L) |
| 207Y00000X Otolaryngology (Licence: MN 78626) | |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2025-09-18 |