| NPI | 1255350864 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: FL ME88962) |
| Additional Taxonomies | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: FL ME88962) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2016-05-04 |