| NPI | 1619991015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CT 026681) |
| Additional Taxonomies | 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: CT 026681) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2009-07-02 |