| NPI | 1750814935 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NJ 25MB11797300) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NY 316770) |
| Enumeration Date | 2017-04-05 |
| Last Update Date | 2025-08-21 |