| NPI | 1366443384 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: FL ME38748) | 
| Additional Taxonomies | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: FL ME38748) | 
| 207YS0012X Otolaryngology, Sleep Medicine (Licence: FL ME38748) | |
| 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: FL ME38748) | |
| Enumeration Date | 2005-08-02 | 
| Last Update Date | 2022-09-23 |