| NPI | 1225086598 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NY 208640) |
| Additional Taxonomies | 174400000X Specialist (Licence: 708640) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2009-12-23 |