| NPI | 1629192463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: NJ 25mb08219200) |
| Additional Taxonomies | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: MI 501015425) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2021-12-30 |