| NPI | 1417131434 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: NY 280195) |
| Additional Taxonomies | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: KY 41490) |
| Enumeration Date | 2007-12-27 |
| Last Update Date | 2015-10-02 |