| NPI | 1881984169 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: PA MD455806) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NJ 25MA09901100) |
| Enumeration Date | 2011-04-07 |
| Last Update Date | 2018-03-17 |