| NPI | 1437538881 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology Facial Plastic Surgery (Licence: MA 288000) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MA 288000) |
| 207YX0905X Otolaryngology Otolaryngology/Facial Plastic Surgery (Licence: NY 303409) | |
| Enumeration Date | 2015-05-19 |
| Last Update Date | 2023-04-26 |