| NPI | 1952490807 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA C55473) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: VA 0101233261) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2017-05-11 |