| NPI | 1548260078 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: TX G4841) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX G4841) |
| Enumeration Date | 2005-07-27 |
| Last Update Date | 2024-08-27 |