| NPI | 1114105129 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: OH 34.012159) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA 2OA12385) |
| Enumeration Date | 2008-02-01 |
| Last Update Date | 2023-10-16 |