| NPI | 1215226568 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA A156016) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: WA ML60224673) |
| Enumeration Date | 2011-04-06 |
| Last Update Date | 2018-09-08 |