| NPI | 1215222518 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: FL ME157388) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: PA MT199868) |
| 207Y00000X Otolaryngology (Licence: MD D85532) | |
| Enumeration Date | 2011-06-14 |
| Last Update Date | 2022-07-21 |