| NPI | 1033127006 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: PA MD441427) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: FL ME92345) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2017-05-18 |