NPI | 1922416387 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: NJ 25MB06847100) |
Additional Taxonomies | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: NJ 25MB06847100) |
208D00000X General Practice (Licence: NJ 25MB06847100) | |
Enumeration Date | 2014-07-30 |
Last Update Date | 2023-12-12 |