| NPI | 1083820518 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NJ 25MA08380800) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: DC MD036475) |
| 207YP0228X Otolaryngology Pediatric Otolaryngology (Licence: NJ 25MA08380800) | |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2021-03-23 |