| NPI | 1659359644 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: OH 35.084096) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OH 35-084096N) |
| Enumeration Date | 2006-01-09 |
| Last Update Date | 2026-02-13 |