| NPI | 1174966188 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: MA 281308) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA A155775) |
| Enumeration Date | 2013-04-09 |
| Last Update Date | 2024-09-17 |