| NPI | 1851558936 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology Facial Plastic Surgery (Licence: NY 249535) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NY 249535) |
| Enumeration Date | 2008-05-17 |
| Last Update Date | 2019-04-03 |