| NPI | 1437387297 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: MI 4301092209) |
| Additional Taxonomies | 207YP0228X Otolaryngology Pediatric Otolaryngology (Licence: MI 4301092209) |
| Enumeration Date | 2009-06-30 |
| Last Update Date | 2019-08-27 |