| NPI | 1699338491 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NJ 25MA12609200) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OH 35.150146) |
| Enumeration Date | 2019-04-17 |
| Last Update Date | 2025-06-04 |