| NPI | 1891851812 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology Pediatric Otolaryngology (Licence: PA MD431213) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: PA MT184710) |
| 207Y00000X Otolaryngology (Licence: PA MD431213) | |
| 207YP0228X Otolaryngology Pediatric Otolaryngology (Licence: NJ 25MA08862500) | |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2016-02-26 |