| NPI | 1013953371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MN 37403) |
| Additional Taxonomies | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: MN 37403) |
| 2086S0120X Surgery, Pediatric Surgery (Licence: MN 37403) | |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2024-07-15 |