| NPI | 1699918193 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WA 60741606) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA A114967) |
| Enumeration Date | 2009-04-14 |
| Last Update Date | 2021-04-27 |