| NPI | 1033679766 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NY 329326) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA A202702) |
| 207Y00000X Otolaryngology (Licence: NJ 25MA12194900) | |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2025-10-24 |