| NPI | 1952356651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: NJ 57426) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NJ 57426) |
| 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: NJ 57426) | |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2010-06-28 |