| NPI | 1841607744 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NY 289459) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CT 82722) |
| Enumeration Date | 2014-07-13 |
| Last Update Date | 2025-10-07 |