| NPI | 1205045655 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: CO DR.0052505) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: IA R7631) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2018-11-07 |