| NPI | 1952528572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MI 4301080097) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: WY 7733A) |
| 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: WY 7733A) | |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2015-01-26 |