| NPI | 1245593425 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TN 65717) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA A146049) |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2022-07-20 |