| NPI | 1477113116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YX0905X Otolaryngology Otolaryngology/Facial Plastic Surgery (Licence: CA A196402) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: PA MT217956) |
| Enumeration Date | 2019-06-14 |
| Last Update Date | 2024-07-01 |