| NPI | 1255331781 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: TX H7913) |
| Additional Taxonomies | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: TX H7913) |
| Enumeration Date | 2005-07-27 |
| Last Update Date | 2024-03-12 |