| NPI | 1154471977 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: FL ME96710) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA A92285) |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2018-12-10 |