| NPI | 1710247051 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA A154191) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NY 287823) |
| Enumeration Date | 2012-05-21 |
| Last Update Date | 2021-12-03 |