| NPI | 1245736248 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: TX V2019) |
| Additional Taxonomies | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: UT 13293935-1205) |
| Enumeration Date | 2018-03-30 |
| Last Update Date | 2024-06-25 |