| NPI | 1629002266 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: OH 35.055012) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OH 35-055012) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2011-08-19 |