| NPI | 1275952756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NY 280289) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: GA 082189) |
| Enumeration Date | 2014-04-10 |
| Last Update Date | 2020-10-28 |