| NPI | 1245758028 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: FL ME169250) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA 184650) |
| 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: CA 184650) | |
| Enumeration Date | 2017-08-31 |
| Last Update Date | 2024-10-20 |