| NPI | 1538263009 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: WV 16660)  | 
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: WV 16660)  | 
| Enumeration Date | 2006-09-12 | 
| Last Update Date | 2025-09-11 |