| NPI | 1013371657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NJ 25MA11062200) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: PA MD473885) |
| Enumeration Date | 2016-04-10 |
| Last Update Date | 2022-06-30 |