| NPI | 1588976328 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: UT 9712365-1205) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: UT 9712365-1205) |
| Enumeration Date | 2010-07-09 |
| Last Update Date | 2017-10-20 |