| NPI | 1952374258 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WA 60257137) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: ND 11826) |
| 208D00000X General Practice (Licence: NE 22766) | |
| 207Y00000X Otolaryngology (Licence: NE 22766) | |
| 207Y00000X Otolaryngology (Licence: WA MD60257137) | |
| 207Y00000X Otolaryngology (Licence: CA AFE102255) | |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2022-10-13 |