| NPI | 1851711782 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TN 61177) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA A160888) |
| Enumeration Date | 2014-04-17 |
| Last Update Date | 2022-03-14 |