| NPI | 1184820201 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: NJ 25MA09318800) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NJ 25MA09318800) |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2021-04-05 |