| NPI | 1376049262 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: AZ 71753) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA A164031) |
| Enumeration Date | 2018-04-01 |
| Last Update Date | 2024-06-30 |