| NPI | 1598791543 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NY 2398491) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NJ 25MA10552900) |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2022-02-23 |