| NPI | 1316678881 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA SPI-843) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MA 0) |
| 207Y00000X Otolaryngology (Licence: MA 294762) | |
| Enumeration Date | 2022-06-23 |
| Last Update Date | 2024-08-26 |