| NPI | 1457342644 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: TN MD0000044593) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MA 47542) |
| 208000000X Pediatrics (Licence: MA 47542) | |
| Enumeration Date | 2005-11-04 |
| Last Update Date | 2022-03-31 |