| NPI | 1659598662 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: TX Q8021) | 
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NY 243687) | 
| 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: DC MD038814) | |
| 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: MD D72854) | |
| Enumeration Date | 2007-04-19 | 
| Last Update Date | 2025-02-21 |