| NPI | 1215076807 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TN MD48597) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA A116906) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2022-03-14 |