| NPI | 1952339806 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: NY 179541) |
| Additional Taxonomies | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: NY 179541) |
| 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: NY 179541) | |
| 207YX0901X Otolaryngology, Otology & Neurotology (Licence: NY 179541) | |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2012-10-03 |