| NPI | 1518923119 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: OH 35-081746) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OH 35081746) |
| 207Y00000X Otolaryngology (Licence: NY 239521) | |
| 207Y00000X Otolaryngology (Licence: OH 35-081746) | |
| Enumeration Date | 2006-04-22 |
| Last Update Date | 2022-04-12 |