| NPI | 1477547180 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: VA 0101246718) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MD D0039596) |
| 207Y00000X Otolaryngology (Licence: FL ME 106238) | |
| Enumeration Date | 2005-09-08 |
| Last Update Date | 2016-09-06 |