| NPI | 1114093598 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: FL ME72673) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL 0072673) |
| 207Y00000X Otolaryngology (Licence: SC MD82186) | |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2024-05-12 |