| NPI | 1235179995 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NY 213707) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 213707) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2019-09-27 |