| NPI | 1285747824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: SC 28029) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: SC 28029) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2020-10-22 |