| NPI | 1841480274 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NJ 25MA09513900) |
| Additional Taxonomies | 207YS0012X (Licence: NJ 25MA09513900) |
| 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: NJ 25MA09513900) | |
| Enumeration Date | 2007-08-01 |
| Last Update Date | 2020-07-30 |