| NPI | 1043427172 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: PA md430930) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NJ 25MA10102000) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2019-06-25 |