NPI | 1740815950 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: TX 48682) |
Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TX 48682) |
Enumeration Date | 2020-03-08 |
Last Update Date | 2025-09-22 |