| NPI | 1366419129 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: GA 079175) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NY 198569) |
| Enumeration Date | 2006-03-01 |
| Last Update Date | 2018-10-11 |