| NPI | 1598076184 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: RI MD16558) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NY 280128) |
| 207Y00000X Otolaryngology (Licence: NJ 25MA09950700) | |
| Enumeration Date | 2010-06-29 |
| Last Update Date | 2023-03-07 |