| NPI | 1114419355 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA A186423) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: IA R-11245) |
| Enumeration Date | 2018-06-04 |
| Last Update Date | 2023-06-20 |