| NPI | 1295120681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WA MD61292121) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA A168207) |
| Enumeration Date | 2015-04-01 |
| Last Update Date | 2023-08-03 |