| NPI | 1841491487 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: WA 60456988) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NE 24424) |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2023-06-06 |