| NPI | 1285617381 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0012X (Licence: NY 207511-1) |
| Additional Taxonomies | 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: NY 207577-1) |
| 207Y00000X Otolaryngology (Licence: NY 207511-1) | |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2019-04-02 |