| NPI | 1447493416 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WA MD60921000) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA A128811) |
| 207Y00000X Otolaryngology (Licence: GA 73869) | |
| Enumeration Date | 2009-04-07 |
| Last Update Date | 2019-04-13 |