| NPI | 1255828778 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NY 329288) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: FL ME159480) |
| Enumeration Date | 2018-04-19 |
| Last Update Date | 2024-05-07 |