| NPI | 1316975220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NJ 25MA07485400) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: PA MD060574L) |
| 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: NJ 25MA07485400) | |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2019-01-22 |