| NPI | 1457330250 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: FL ME157926) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: WI 43001) |
| 207YX0901X Otolaryngology, Otology & Neurotology (Licence: FL ME157926) | |
| Enumeration Date | 2006-01-11 |
| Last Update Date | 2025-11-24 |