| NPI | 1487155578 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YX0901X Otolaryngology Otology & Neurotology (Licence: NY 321171) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: IA MD-46986) |
| Enumeration Date | 2018-02-23 |
| Last Update Date | 2025-08-11 |