| NPI | 1508073321 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: NJ 25MA08795100) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NJ 25MA08795100) |
| 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: NY 251990) | |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2025-07-25 |