| NPI | 1548277882 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: TX J6864) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TX J6864) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2022-09-30 |