| NPI | 1477715696 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: WA MD 60340296) |
| Additional Taxonomies | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: OH 35.097031) |
| Enumeration Date | 2008-06-29 |
| Last Update Date | 2013-07-13 |