| NPI | 1124020557 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: FL ME68587) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME0068587) |
| Enumeration Date | 2005-08-15 |
| Last Update Date | 2021-04-29 |