| NPI | 1841224847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NJ MA068878) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NY 1989031) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2012-05-20 |