| NPI | 1447260633 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: GA 030684) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: GA 030684) |
| 207KA0200X Allergy & Immunology, Allergy (Licence: GA 030684) | |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2007-12-11 |