| NPI | 1558462556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: NJ MA067103) |
| Additional Taxonomies | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: NY 2019411) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2007-07-08 |