| NPI | 1972537892 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology Otolaryngology/Facial Plastic Surgery (Licence: ID O-0409) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology Allergy (Licence: ID O-0409) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2014-06-11 |