| NPI | 1528070844 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: CA C165904) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MN 57963) |
| 207Y00000X Otolaryngology (Licence: OH 35.098513) | |
| 207Y00000X Otolaryngology (Licence: WI 68843) | |
| 207Y00000X Otolaryngology (Licence: WA ML20008190) | |
| 207Y00000X Otolaryngology (Licence: CA C165904) | |
| 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: MN 57963) | |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2024-04-28 |