| NPI | 1265536445 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: ME md18388) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MO 2009014370) |
| 207Y00000X Otolaryngology (Licence: MO T2004016418) | |
| Enumeration Date | 2006-09-11 |
| Last Update Date | 2025-12-03 |