| NPI | 1104938091 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: OR MD157387) |
| Additional Taxonomies | 207YP0228X Otolaryngology Pediatric Otolaryngology (Licence: OR 157387) |
| 207Y00000X Otolaryngology (Licence: WA ML20007565) | |
| 207YP0228X Otolaryngology Pediatric Otolaryngology (Licence: OH 35.095296) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2023-11-14 |