| 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 (Licence: FL ME38748) | |
| 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: FL ME38748) | |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2022-09-23 |