| NPI | 1790781698 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NC 31262) |
| Additional Taxonomies | 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: NC 31262) |
| Enumeration Date | 2005-06-24 |
| Last Update Date | 2015-10-22 |