| NPI | 1093788853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA G52273) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA G052273) |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2020-06-12 |