| NPI | 1801898796 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA G56517) |
| Additional Taxonomies | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: CA G56517) |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2024-04-29 |