| NPI | 1467438861 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MA 233780) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 098420) |
| Enumeration Date | 2005-12-16 |
| Last Update Date | 2014-06-16 |