| NPI | 1184661340 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: CO DR.0071170) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: SC 30640) |
| 207Y00000X Otolaryngology (Licence: OH 35084914) | |
| 207Y00000X Otolaryngology (Licence: IN 01084434A) | |
| 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: SC 30640) | |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2025-02-18 |