| NPI | 1306800404 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: WI 3792) | 
| Additional Taxonomies | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: GA 039054) | 
| 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: TX U4672) | |
| Enumeration Date | 2006-04-14 | 
| Last Update Date | 2024-03-14 |