| NPI | 1427682368 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: FL ME144781) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: ZZ 025585) |
| Enumeration Date | 2020-03-01 |
| Last Update Date | 2020-06-08 |