NPI | 1013905173 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207YP0228X Otolaryngology Pediatric Otolaryngology (Licence: NY 258074) |
Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NY 258074) |
Enumeration Date | 2005-10-12 |
Last Update Date | 2014-08-07 |