| NPI | 1215023023 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: FL ME0044406) |
| Additional Taxonomies | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: FL ME44406) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2019-05-03 |