| NPI | 1154355493 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: FL ME137189) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: LA 024704) |
| 2083C0008X Preventive Medicine, Clinical Informatics Specialist (Licence: FL ME137189) | |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2023-11-02 |