| NPI | 1477973220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: FL ME168242) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TX T9183) |
| Enumeration Date | 2014-04-21 |
| Last Update Date | 2024-09-27 |