| NPI | 1174549398 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: FL ME126033) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MO R1J88) |
| 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: FL ME126033) | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2025-02-17 |