| NPI | 1073545034 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: FL ME0032360) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: FL ME032360) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2013-03-27 |