| NPI | 1962459875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NY 188631) |
| Additional Taxonomies | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: NY 188631) |
| 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: NY 188631) | |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2016-11-11 |