| NPI | 1538189147 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: LA 312034) |
| Additional Taxonomies | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: OH 35.084305) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2020-03-03 |