| NPI | 1407823404 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: NJ 25MA06263000) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NJ 25MA06263000) |
| 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: NJ 25MA06263000) | |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2012-07-11 |