| NPI | 1629048202 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CO 51270) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA GFE76870) |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2021-06-07 |