| NPI | 1376598805 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NY 254098) |
| Additional Taxonomies | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: NY 254098) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2021-03-30 |