| NPI | 1831143619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NC NC 34749) |
| Additional Taxonomies | 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: NC NC34749) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2009-12-07 |