| NPI | 1124380084 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: SC 34941) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: SC 34941) |
| 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: MN 61846) | |
| 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: GA 79892) | |
| Enumeration Date | 2012-06-15 |
| Last Update Date | 2020-10-23 |