| NPI | 1780670570 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CT 15098) |
| Additional Taxonomies | 207YX0007X Otolaryngology Plastic Surgery within the Head & Neck (Licence: CT 15098) |
| 207YX0602X Otolaryngology Otolaryngic Allergy (Licence: CT 15098) | |
| Enumeration Date | 2005-09-27 |
| Last Update Date | 2007-07-08 |