| NPI | 1942236989 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CT 027282) |
| Additional Taxonomies | 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: CT 027282) |
| 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: CT 027282) | |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2018-02-22 |