| NPI | 1649318577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: CA G85741) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA G85741) |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2024-04-28 |