| NPI | 1578344990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: MA 1023406) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: ZZ 119163) |
| Enumeration Date | 2023-10-11 |
| Last Update Date | 2025-05-09 |