| NPI | 1326145939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NJ MA36071) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA G39473) |
| 207Y00000X Otolaryngology (Licence: NY 1353961) | |
| Enumeration Date | 2006-09-19 |
| Last Update Date | 2007-07-08 |