| NPI | 1902887730 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0012X Otolaryngology, Sleep Medicine (Licence: NY 172268) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NY 172268-1) |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2019-01-23 |