| NPI | 1407943673 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: MI 4301057683) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MI 4301057683) |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2019-11-25 |