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 |