| NPI | 1346700234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: OH 35.153906) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TX V1767) |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2025-07-30 |