| NPI | 1629168117 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: TN MD43893) |
| Additional Taxonomies | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: FL ME98192) |
| 207Y00000X Otolaryngology (Licence: AR E3414) | |
| 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: AR E3414) | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2009-01-15 |