| NPI | 1588683635 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NJ 25MA05304700) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OH 35066861) |
| 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: NJ 25MA05304700) | |
| 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: OH 35066861) | |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2020-12-15 |