| NPI | 1902856263 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NH 10686) |
| Additional Taxonomies | 174400000X Specialist (Licence: NH 10686) |
| 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: NH 10686) | |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2015-01-08 |