| NPI | 1740238765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YX0602X Otolaryngology Otolaryngic Allergy (Licence: WV 9578) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: WV 5862) |
| 207Y00000X Otolaryngology (Licence: WV 9578) | |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2020-12-07 |