| NPI | 1750559902 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX N2728) |
| Additional Taxonomies | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: TX N2728) |
| 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: TX N2728) | |
| Enumeration Date | 2008-02-11 |
| Last Update Date | 2013-10-01 |