| NPI | 1073581740 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: FL ME163925) |
| Additional Taxonomies | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: NJ ma042686) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2023-09-19 |