| NPI | 1205909603 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA G81045) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA G81045) |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2021-02-11 |