| NPI | 1457567471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: MA 245003) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MA 245003) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2024-03-01 |