| NPI | 1447693973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: CA A123456) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA A137267) |
| Enumeration Date | 2013-04-15 |
| Last Update Date | 2026-02-05 |