| NPI | 1083716500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NY 141640) |
| Additional Taxonomies | 207YX0901X Otolaryngology Otology & Neurotology (Licence: NY 141640) |
| 237700000X Hearing Instrument Specialist (Licence: NY 14000010120) | |
| Enumeration Date | 2006-09-04 |
| Last Update Date | 2019-04-02 |