| NPI | 1922413343 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: OK 67805) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: GA 6781) |
| Enumeration Date | 2014-06-24 |
| Last Update Date | 2021-11-09 |