| NPI | 1740271071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WI 22384) |
| Additional Taxonomies | 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: WI 22384) |
| Enumeration Date | 2005-11-04 |
| Last Update Date | 2011-09-28 |