| NPI | 1487909990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX Q7633) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA A121674) |
| Enumeration Date | 2012-07-20 |
| Last Update Date | 2016-10-28 |