| NPI | 1861439481 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: NJ 25MB05069700) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NJ 25MB05069700) |
| 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: NJ 25MB05069700) | |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2012-01-03 |