| NPI | 1033189758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: FL ME74096) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MO 2020032069) |
| 207Y00000X Otolaryngology (Licence: AL 41782) | |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2025-08-12 |