| NPI | 1457765224 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MA 283435) |
| Additional Taxonomies | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: MA 283435) |
| Enumeration Date | 2014-06-19 |
| Last Update Date | 2020-07-16 |