| NPI | 1003127556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: FL ME160536) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MD D87667) |
| 207Y00000X Otolaryngology (Licence: VA 0101250178) | |
| 207Y00000X Otolaryngology (Licence: DC MD048682) | |
| 207Y00000X Otolaryngology (Licence: TX T3788) | |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2023-06-08 |