| NPI | 1871538900 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: PA MD035533E) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NJ 25MA05374200) |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2014-07-29 |