| NPI | 1124091970 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NV 8547) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA G58187) |
| 207YX0901X Otolaryngology, Otology & Neurotology (Licence: NV 8547) | |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2024-01-25 |