| NPI | 1619934460 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NY 208436) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NJ MA68818) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2007-07-09 |