| NPI | 1588602528 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: OH 35.063446) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: WV 15959) |
| 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: WV 15959) | |
| 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: FL ME108726) | |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2018-05-02 |