| NPI | 1780782854 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA C137438) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: GA 51823) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2023-11-27 |