| NPI | 1235572306 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: WI 3129) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OH 57.022827) |
| 207Y00000X Otolaryngology (Licence: MN 67048) | |
| Enumeration Date | 2013-04-09 |
| Last Update Date | 2023-09-13 |