| NPI | 1427411883 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: FL ME150000) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: FL 150000) |
| Enumeration Date | 2016-04-03 |
| Last Update Date | 2023-09-26 |