| NPI | 1689012924 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: NJ 25MA10500500) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: PA MD464322) |
| 207Y00000X Otolaryngology (Licence: NJ 25MA10500500) | |
| Enumeration Date | 2013-06-10 |
| Last Update Date | 2021-01-08 |