| NPI | 1689712606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YX0905X Otolaryngology Otolaryngology/Facial Plastic Surgery (Licence: DE C20004052) |
| Additional Taxonomies | 207KI0005X Allergy & Immunology Clinical & Laboratory Immunology (Licence: NJ 25MB06984800) |
| 207YX0905X Otolaryngology Otolaryngology/Facial Plastic Surgery (Licence: PA OS004431L) | |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2009-11-05 |