| NPI | 1992771174 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: AR R3276) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: AR R3276) |
| 207K00000X Allergy & Immunology (Licence: AR R3276) | |
| 207KA0200X Allergy & Immunology Allergy (Licence: AR R3276) | |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2019-04-30 |