| NPI | 1902466527 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NJ 25MA12640300) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: PA MD483973) |
| Enumeration Date | 2019-06-17 |
| Last Update Date | 2025-06-25 |