| NPI | 1790314698 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: CO DR.0075018) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CO DR.0075018) |
| Enumeration Date | 2020-04-03 |
| Last Update Date | 2025-09-30 |