| NPI | 1649234709 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NY 124099) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 124099) |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2022-07-21 |