| NPI | 1033504196 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YP0228X Otolaryngology Pediatric Otolaryngology (Licence: TN 63507) |
| Additional Taxonomies | 207YX0007X Otolaryngology Plastic Surgery within the Head & Neck (Licence: TN 63507) |
| 207YP0228X Otolaryngology Pediatric Otolaryngology (Licence: WA ML.61061354) | |
| Enumeration Date | 2015-04-04 |
| Last Update Date | 2024-04-09 |