| NPI | 1538453634 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA A143533) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: FL TRN16133) |
| Enumeration Date | 2011-06-06 |
| Last Update Date | 2021-04-19 |