| NPI | 1710606512 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: CA SPI731) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA SPI731) |
| Enumeration Date | 2022-08-24 |
| Last Update Date | 2024-04-29 |