| NPI | 1245269521 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YP0228X Otolaryngology Pediatric Otolaryngology (Licence: PA MD418751) |
| Additional Taxonomies | 207YP0228X Otolaryngology Pediatric Otolaryngology (Licence: GA 53618) |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2013-04-11 |