| NPI | 1861595662 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0012X (Licence: CO 38814) |
| Additional Taxonomies | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: CO 38814) |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2019-01-28 |