NPI | 1154411783 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207YP0228X Otolaryngology Pediatric Otolaryngology (Licence: UT 333284-1205) |
Additional Taxonomies | 207Y00000X Otolaryngology (Licence: UT 333284-1205) |
Enumeration Date | 2006-10-13 |
Last Update Date | 2021-11-17 |