| NPI | 1427018191 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: UT 186744-1205) |
| Additional Taxonomies | 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: UT 186744-1205) |
| Enumeration Date | 2006-03-25 |
| Last Update Date | 2010-06-29 |