| NPI | 1780027292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: NY 291858) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NY 291858) |
| Enumeration Date | 2013-04-15 |
| Last Update Date | 2018-11-09 |