| NPI | 1427286673 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: FL ME152581) |
| Additional Taxonomies | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: OH 35.128526) |
| Enumeration Date | 2009-06-26 |
| Last Update Date | 2021-10-08 |