| NPI | 1831234632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CO 15058) |
| Additional Taxonomies | 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: CO 15058) |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2007-10-10 |