| NPI | 1770686214 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NY 132096) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: FL 29360) |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2007-07-08 |