| NPI | 1538483854 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX N8175) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA A110623) |
| Enumeration Date | 2010-03-15 |
| Last Update Date | 2021-01-13 |