| NPI | 1902857758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: WI 34145) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: WI 34145) |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2017-07-17 |