NPI | 1518429315 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: WA MD.MD61687221) |
Additional Taxonomies | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: CA A195313) |
Enumeration Date | 2019-04-02 |
Last Update Date | 2025-09-08 |