| NPI | 1447230354 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: FL ME58920) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: FL ME0058920) |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2018-10-19 |