| NPI | 1942312921 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MO R8584) |
| Additional Taxonomies | 207YX0602X Otolaryngology Otolaryngic Allergy (Licence: MO R8584) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2010-07-14 |