| NPI | 1225579410 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WI 83952) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 83952) |
| Enumeration Date | 2017-03-20 |
| Last Update Date | 2024-08-08 |