| NPI | 1013916428 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: SC 61327) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: FL ME151217) |
| 207Y00000X Otolaryngology (Licence: NC 99-00706) | |
| Enumeration Date | 2005-07-18 |
| Last Update Date | 2024-11-22 |