| NPI | 1588865414 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: OH 35095303) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: PA MT184252) |
| 207Y00000X Otolaryngology (Licence: OH 35095303) | |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2022-03-02 |