| NPI | 1083239529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NH 34482) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: ME DO4072) |
| Enumeration Date | 2020-06-10 |
| Last Update Date | 2025-06-19 |