| NPI | 1063483709 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NY 178508) |
| Additional Taxonomies | 207YS0012X Otolaryngology, Sleep Medicine (Licence: NY 178508) |
| Enumeration Date | 2006-01-31 |
| Last Update Date | 2019-04-02 |