| NPI | 1366442154 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: PA MD062982L) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: PA MD062982L) |
| Enumeration Date | 2005-07-22 |
| Last Update Date | 2020-10-01 |