| NPI | 1487666525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: FL ME164208) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: HI 12533) |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2024-02-06 |