| NPI | 1063656882 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NJ 25MB08701400) |
| Additional Taxonomies | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: PA os014059) |
| Enumeration Date | 2009-04-23 |
| Last Update Date | 2019-04-01 |