| NPI | 1437134210 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX U0561) |
| Additional Taxonomies | 207YP0228X Otolaryngology Pediatric Otolaryngology (Licence: TX U0561) |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2023-03-16 |