| NPI | 1770561235 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: MA 51671) |
| Additional Taxonomies | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: MA 51671) |
| 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: MA 15671) | |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2013-12-09 |