| NPI | 1184668634 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: PA MD070356L) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NJ 25MA05907000) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2009-11-05 |