| NPI | 1093865594 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: CO DR.0060500) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OH 57.022926) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2019-08-12 |