| NPI | 1649618596 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NJ 25MA10604600) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: PA MD463958) |
| Enumeration Date | 2013-06-12 |
| Last Update Date | 2019-09-10 |