| NPI | 1932563772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: NJ 25MA11432100) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NJ 25MA11432100) |
| Enumeration Date | 2016-04-07 |
| Last Update Date | 2023-01-24 |