| NPI | 1275797755 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NJ 25MA08904400) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: PA MD433821) |
| Enumeration Date | 2008-07-15 |
| Last Update Date | 2020-02-19 |