| NPI | 1245260470 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: SC 27632) |
| Additional Taxonomies | 207YS0012X Otolaryngology Sleep Medicine (Licence: SC 27632) |
| 207YX0602X Otolaryngology Otolaryngic Allergy (Licence: SC 27632) | |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2017-01-04 |