| NPI | 1659598662 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: DC MD038814) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NY 243687) |
| 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: MD D72854) | |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2011-08-08 |