| NPI | 1083835003 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: TN MD48822) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TN MD48822) |
| 207Y00000X Otolaryngology (Licence: MN 49691) | |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2018-03-29 |