| NPI | 1568514412 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: NY 236600) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 236600) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2021-01-09 |