| 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 |