| NPI | 1487757779 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA G74828) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: CA G74828) |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2016-01-20 |