| NPI | 1861458960 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0602X Otolaryngology Otolaryngic Allergy (Licence: VA 0101047460) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: VA 0101047460) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2016-12-02 |