| NPI | 1730404435 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: SC 39348) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: VA 0101264722) |
| Enumeration Date | 2010-04-06 |
| Last Update Date | 2018-06-28 |