| NPI | 1356309561 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NH 8107) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NH 8107) |
| 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: NH 8107) | |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2007-11-01 |