| NPI | 1649512070 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NJ 25MA10557200) |
| Additional Taxonomies | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: NJ 25MA10557200) |
| Enumeration Date | 2013-03-24 |
| Last Update Date | 2021-05-06 |