| NPI | 1255355202 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NY 220674) |
| Additional Taxonomies | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: NY 220674) |
| 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: NY 220674) | |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2023-07-06 |