| NPI | 1295871879 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NY 228604) |
| Additional Taxonomies | 207YP0228X Otolaryngology Pediatric Otolaryngology (Licence: NY 228604) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2018-03-17 |