| NPI | 1669471751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: LA 009866) |
| Additional Taxonomies | 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: LA 009866) |
| 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: LA 009866) | |
| Enumeration Date | 2005-07-20 |
| Last Update Date | 2007-11-16 |