| NPI | 1043283898 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: FL ME110071) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NV 10450) |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2012-06-04 |