| NPI | 1073687539 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA G20429) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: WA MD60030905) |
| 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: WA MD60030905) | |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2022-11-03 |