| NPI | 1053377457 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: LA MD.025251) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: FL ME139730) |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2022-02-21 |