| NPI | 1831331693 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA C200972) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NJ 25MA10959800) |
| 207Y00000X Otolaryngology (Licence: NY 274646) | |
| Enumeration Date | 2009-03-25 |
| Last Update Date | 2026-01-07 |