| NPI | 1508219767 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NY 286096) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OH 35.138159) |
| 207Y00000X Otolaryngology (Licence: MA 286468) | |
| Enumeration Date | 2016-07-22 |
| Last Update Date | 2024-03-04 |