| NPI | 1831413608 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: OH 35.144394) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NY 278551-1) |
| Enumeration Date | 2010-03-22 |
| Last Update Date | 2022-05-10 |