| NPI | 1770536062 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: MN 43711) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MN 43711) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2017-01-31 |