| NPI | 1710961198 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: NY 181365) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 104553) |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2024-06-18 |