| NPI | 1790275873 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: OH 35.150748) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OH 35.150748) |
| Enumeration Date | 2018-05-15 |
| Last Update Date | 2024-12-03 |