| NPI | 1346243011 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology Pediatric Otolaryngology (Licence: CA G65618) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA G65618) |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2020-12-10 |