| NPI | 1225205891 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 257771) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: ZZ 30949) |
| Enumeration Date | 2008-05-13 |
| Last Update Date | 2024-01-19 |