| NPI | 1407817562 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NY 191172) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NJ 25MA06414200) |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2019-01-29 |