| NPI | 1851356695 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NC 35920) |
| Additional Taxonomies | 174400000X Specialist (Licence: NC 35920) |
| 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: NC 35920) | |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2015-10-22 |