| NPI | 1619015229 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA C205669) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MD D69781) |
| Enumeration Date | 2007-02-03 |
| Last Update Date | 2026-02-18 |