| NPI | 1255355442 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: FL ME0038666) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME38666) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2012-05-11 |