| NPI | 1477986420 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: PA OS020956) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NJ 25MB10524200) |
| Enumeration Date | 2013-08-14 |
| Last Update Date | 2024-11-19 |