| NPI | 1568433548 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: KY 39623) |
| Additional Taxonomies | 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: TN 43018) |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2023-03-07 |