| NPI | 1104885003 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NJ 25MA11219200) |
| Additional Taxonomies | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: NJ 25MA11219200) |
| Enumeration Date | 2006-03-20 |
| Last Update Date | 2025-04-08 |