| NPI | 1518947977 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MI NO054737) |
| Additional Taxonomies | 207YX0007X Otolaryngology Plastic Surgery within the Head & Neck (Licence: MI NO054737) |
| 207YX0602X Otolaryngology Otolaryngic Allergy (Licence: MI NO054737) | |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2008-05-16 |