| NPI | 1558519918 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NJ 25MA09051100) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NY FG2657003) |
| Enumeration Date | 2008-08-28 |
| Last Update Date | 2012-11-13 |