| NPI | 1427898089 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: CA SPI830)  | 
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA SPI830)  | 
| Enumeration Date | 2024-05-30 | 
| Last Update Date | 2024-08-06 |