| NPI | 1962181529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology Pediatric Otolaryngology (Licence: CA SPI775) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA SPI775) |
| Enumeration Date | 2023-07-12 |
| Last Update Date | 2024-04-29 |