| NPI | 1497862353 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: FL ME158055) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: AL 27490) |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2025-04-03 |