| NPI | 1316936115 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: MO 108562) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MO 108562) |
| Enumeration Date | 2005-10-14 |
| Last Update Date | 2017-06-16 |