| NPI | 1093858581 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: AR E5742) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35.088306) |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2008-12-10 |