| NPI | 1285121319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: CA A165269) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA A165269) |
| 207Y00000X Otolaryngology (Licence: CO DR.0070758) | |
| Enumeration Date | 2018-04-14 |
| Last Update Date | 2024-06-25 |