| NPI | 1114023520 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 120296) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NJ W23126514C) |
| 207Y00000X Otolaryngology (Licence: NY 120296) | |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2024-01-31 |