| NPI | 1528166287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: OR MD27455) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: CA A40097) |
| 207P00000X Emergency Medicine (Licence: CA A40097) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2010-03-23 |