| NPI | 1467446542 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MA 47040) |
| Additional Taxonomies | 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: MA 47040) |
| Enumeration Date | 2005-09-06 |
| Last Update Date | 2011-12-09 |