| NPI | 1417945320 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: GA 041654) |
| Additional Taxonomies | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: GA 041654) |
| 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: GA 041654) | |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2009-12-18 |