| NPI | 1528086717 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: FL ME81383)  | 
| Additional Taxonomies | 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: FL ME81383)  | 
| 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: FL ME81383)  | |
| Enumeration Date | 2006-07-17 | 
| Last Update Date | 2022-12-19 |