| NPI | 1225105414 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NJ MA069506) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NY 214572) |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2015-12-14 |