| NPI | 1992861850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NJ 25MA08401400) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: PA MT180616) |
| 207Y00000X Otolaryngology (Licence: MI 4301089070) | |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2019-07-23 |