| NPI | 1417480013 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: FL ME164061) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA A179274) |
| 207Y00000X Otolaryngology (Licence: FL ME164061) | |
| Enumeration Date | 2017-04-10 |
| Last Update Date | 2024-04-29 |