| NPI | 1184141798 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NJ 25MA12396700) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NY p06162) |
| Enumeration Date | 2017-08-24 |
| Last Update Date | 2025-10-09 |