| NPI | 1396126017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: MI 4301509127) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: KY R3880) |
| 207Y00000X Otolaryngology (Licence: WV 30305) | |
| 207Y00000X Otolaryngology (Licence: MI 4301509127) | |
| Enumeration Date | 2015-06-18 |
| Last Update Date | 2023-09-15 |