| NPI | 1740815950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX 47668) |
| Additional Taxonomies | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: TX 47057) |
| 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: TX 47668) | |
| Enumeration Date | 2020-03-08 |
| Last Update Date | 2022-09-12 |