| NPI | 1598030827 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: CA A202236) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: PA MD474986) |
| Enumeration Date | 2012-03-20 |
| Last Update Date | 2025-08-30 |