| NPI | 1760620850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NY 260938) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: DC 153397) |
| Enumeration Date | 2009-01-27 |
| Last Update Date | 2019-04-02 |