| NPI | 1053317461 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA G52842) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA G52842) |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2021-02-02 |