| NPI | 1407019144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA A112816) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NY 239790) |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2024-04-29 |