| NPI | 1699785014 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA G59056) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NH LT4368) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2022-11-16 |