| NPI | 1316962350 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA G52817) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OR MD24876) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2022-07-21 |