| NPI | 1912975772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA A30230) |
| Additional Taxonomies | 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: CA A30230) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2019-08-28 |