| NPI | 1497169221 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA A175180) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: VA 0116030998) |
| 183500000X Pharmacist (Licence: GA RPH 024880) | |
| Enumeration Date | 2014-06-19 |
| Last Update Date | 2024-10-03 |