| NPI | 1265619696 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: GA 78940) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TX P2593) |
| 207Y00000X Otolaryngology (Licence: PA MD441701) | |
| 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: PA MD441701) | |
| 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: TX P2593) | |
| Enumeration Date | 2008-01-28 |
| Last Update Date | 2018-05-31 |