| NPI | 1205887841 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: FL ME150290) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MD D56050) |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2021-05-26 |