| NPI | 1851612568 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TN MD54264) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA 136706) |
| Enumeration Date | 2010-06-16 |
| Last Update Date | 2022-03-23 |