| NPI | 1356994859 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: AZ 61135) |
| Additional Taxonomies | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: CA 163306) |
| Enumeration Date | 2019-07-23 |
| Last Update Date | 2020-12-10 |