| NPI | 1518906809 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX J0065) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NC 2008-00970) |
| 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: NC 2008-00970) | |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2020-04-29 |