NPI | 1750318424 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: TX U6802) |
Additional Taxonomies | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: AZ 36508) |
2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: OH 35.085331) | |
Enumeration Date | 2006-06-27 |
Last Update Date | 2023-09-19 |