| NPI | 1295981371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: FL ME143358) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MN 51950) |
| Enumeration Date | 2008-08-08 |
| Last Update Date | 2020-08-31 |