| NPI | 1528262839 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: WI 57224) | 
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: WI 57224) | 
| 207Y00000X Otolaryngology (Licence: MI 4301088584) | |
| Enumeration Date | 2007-06-12 | 
| Last Update Date | 2024-03-04 |