| NPI | 1013174481 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: FL ME115462) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: FL ME115462) |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2022-02-07 |