| NPI | 1265876197 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NJ 25MA10953100) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NY 292888) |
| Enumeration Date | 2013-04-22 |
| Last Update Date | 2022-03-25 |