| NPI | 1013329192 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NJ 25MA11660800) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NY 297589) |
| Enumeration Date | 2014-05-23 |
| Last Update Date | 2023-02-16 |