| NPI | 1972788214 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: PA MD433358) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NJ 25MA08362800) |
| Enumeration Date | 2008-01-06 |
| Last Update Date | 2008-12-04 |