| NPI | 1871707919 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NY 252512) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA A79463) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2023-07-06 |