| NPI | 1508429408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NY 337591) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA A194377) |
| Enumeration Date | 2019-04-16 |
| Last Update Date | 2025-12-30 |