| NPI | 1376792606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NJ 25MA09056400) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NY 250301) |
| Enumeration Date | 2008-09-10 |
| Last Update Date | 2019-01-17 |