| NPI | 1760693063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: OH 35.099797) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OH 35.099797) |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2018-04-12 |