| NPI | 1194725143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NJ 25MA05930900) |
| Additional Taxonomies | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: NJ 25MA5930900) |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2025-02-20 |