| NPI | 1649295494 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology Pediatric Otolaryngology (Licence: CO DR.0067700) |
| Additional Taxonomies | 207YP0228X Otolaryngology Pediatric Otolaryngology (Licence: TX M9622) |
| 207YP0228X Otolaryngology Pediatric Otolaryngology (Licence: FL ME71715) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2022-03-23 |