| NPI | 1184707564 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: ME MD20832) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA G40102) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2019-04-22 |