| NPI | 1588717508 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: AR R2390) |
| Additional Taxonomies | 174400000X Specialist (Licence: AR r2390) |
| Enumeration Date | 2007-01-21 |
| Last Update Date | 2008-12-10 |