| NPI | 1487897500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology Pediatric Otolaryngology (Licence: FL ME123156) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NY 258899) |
| 207Y00000X Otolaryngology (Licence: MD D77377) | |
| Enumeration Date | 2009-04-20 |
| Last Update Date | 2023-05-24 |