| NPI | 1710010103 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: NY 251610) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NY 251610) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2019-04-03 |