| NPI | 1285653535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NY 191884-1) |
| Additional Taxonomies | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: NY 191884-1) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2019-04-03 |