| NPI | 1790282440 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NY 339127) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA A165829) |
| Enumeration Date | 2018-04-10 |
| Last Update Date | 2025-09-04 |