| NPI | 1760473128 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: CA A99949) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA A99949) |
| Enumeration Date | 2005-11-03 |
| Last Update Date | 2024-04-28 |