| NPI | 1073546743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: NJ 43060) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NY 140820) |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2022-07-21 |