| NPI | 1164555363 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: VA 0101245011) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA A93257) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2024-03-19 |