| NPI | 1346447661 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: HI MD-21060) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA A119708) |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2021-08-30 |