| NPI | 1508250622 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NJ 25MA11134900) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA A167071) |
| Enumeration Date | 2015-03-26 |
| Last Update Date | 2024-05-02 |