| NPI | 1346398690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: NY 236999) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA A98950) |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2016-09-12 |