| NPI | 1689870073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NJ 25MA09772700) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: PA MD439559) |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2018-04-27 |