| NPI | 1689806580 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NY 265799) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NH LT 3335) |
| 207Y00000X Otolaryngology (Licence: MA 257609) | |
| Enumeration Date | 2009-08-12 |
| Last Update Date | 2023-03-07 |