| NPI | 1386854032 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: FL ME 102892) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN8563) |
| 207Y00000X Otolaryngology (Licence: FL MFC1631) | |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2013-01-25 |