| NPI | 1497915292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NJ 25MA10476100) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: WI 60177) |
| Enumeration Date | 2008-06-15 |
| Last Update Date | 2021-08-23 |