| NPI | 1194303180 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: CO DR.0077017) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CO DR.0077017) |
| Enumeration Date | 2021-03-31 |
| Last Update Date | 2026-08-03 |