| NPI | 1093168668 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: FL MFC1508) |
| Additional Taxonomies | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: FL ME170957) |
| Enumeration Date | 2016-07-19 |
| Last Update Date | 2026-08-25 |