| NPI | 1447293121 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: GA 109818) |
| Additional Taxonomies | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: SC 30117) |
| 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: MA 226983) | |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2026-05-04 |