| NPI | 1598724619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology Pediatric Otolaryngology (Licence: FL OS11438) |
| Additional Taxonomies | 207YP0228X Otolaryngology Pediatric Otolaryngology (Licence: AR E-4158) |
| 207YP0228X Otolaryngology Pediatric Otolaryngology (Licence: TX M8003) | |
| Enumeration Date | 2006-03-18 |
| Last Update Date | 2016-12-14 |