| NPI | 1649367475 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA C30057) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA C30057) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2013-11-25 |