| NPI | 1770796583 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: ID M-10574) |
| Additional Taxonomies | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: ID M-10574) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2026-03-05 |