| NPI | 1073888434 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: NJ 25MA10474800) |
| Additional Taxonomies | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: NY 291195-1) |
| 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: NJ 25MA10474800) | |
| 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: NJ 25MA10474800) | |
| Enumeration Date | 2012-03-19 |
| Last Update Date | 2020-01-31 |