| NPI | 1184714677 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology Pediatric Otolaryngology (Licence: AR C-6793) |
| Additional Taxonomies | 207YX0905X Otolaryngology Otolaryngology/Facial Plastic Surgery (Licence: AR C-6793) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2018-10-05 |