| NPI | 1205057072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NH LT4394) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA A50046) |
| 207Y00000X Otolaryngology (Licence: NY 183818) | |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2023-12-30 |