| NPI | 1356335558 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: NJ MA07891100) |
| Additional Taxonomies | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: NJ MA07891100) |
| Enumeration Date | 2005-09-02 |
| Last Update Date | 2010-07-01 |