NPI | 1649435561 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207YP0228X Otolaryngology Pediatric Otolaryngology (Licence: MA 246760) |
Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MA 246760) |
Enumeration Date | 2008-07-21 |
Last Update Date | 2023-11-08 |