| NPI | 1700016482 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: TX N8935) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TX N8935) |
| Enumeration Date | 2009-07-16 |
| Last Update Date | 2016-01-19 |