| NPI | 1912901570 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX F2111) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy (Licence: TX F2111) |
| Enumeration Date | 2005-06-10 |
| Last Update Date | 2023-08-15 |