| NPI | 1013905173 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: NY 258074) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NY 258074) |
| Enumeration Date | 2005-10-12 |
| Last Update Date | 2014-08-07 |