| NPI | 1417953084 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WV 18329) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: MD D0042166) |
| 207Y00000X Otolaryngology (Licence: MD D0042166) | |
| 207Y00000X Otolaryngology (Licence: NH 13660) | |
| 207YS0012X (Licence: NH 13660) | |
| 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: NH 13660) | |
| Enumeration Date | 2005-06-28 |
| Last Update Date | 2022-04-12 |