| NPI | 1437144235 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: WI 22968) |
| Additional Taxonomies | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: PA 034371-E) |
| Enumeration Date | 2005-09-19 |
| Last Update Date | 2015-04-28 |