| NPI | 1376804369 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MS 24882) |
| Additional Taxonomies | 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: MS 24882) |
| Enumeration Date | 2012-06-06 |
| Last Update Date | 2022-07-21 |