| NPI | 1396890869 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: FL ME100257) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: FL ME100257) |
| 207Y00000X Otolaryngology (Licence: NJ 25MA08197500) | |
| 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: NJ 25MA08197500) | |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2016-11-30 |