| NPI | 1396158069 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: PA MD462595) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NJ 25MA10498800) |
| Enumeration Date | 2014-06-10 |
| Last Update Date | 2021-08-09 |