| NPI | 1821354770 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WA MD61471158) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OH 35134339) |
| 207Y00000X Otolaryngology (Licence: CA A146999) | |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2024-03-19 |