| NPI | 1043453848 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: OH 35130239) |
| Additional Taxonomies | 207YS0012X (Licence: OH 35130239) |
| Enumeration Date | 2009-04-09 |
| Last Update Date | 2017-07-24 |