| NPI | 1205902673 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: FL ME126537) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MI 407013) |
| 207YX0901X Otolaryngology, Otology & Neurotology (Licence: FL ME126537) | |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2020-07-09 |