| NPI | 1952759227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: AZ 69615) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: PA MD476659) |
| Enumeration Date | 2016-05-27 |
| Last Update Date | 2023-08-29 |