| NPI | 1407895477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX M2143) |
| Additional Taxonomies | 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: TX M2143) |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2020-03-09 |