| NPI | 1528301330 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: FL ME136077) |
| Additional Taxonomies | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: FL ME136077) |
| Enumeration Date | 2013-03-29 |
| Last Update Date | 2022-09-21 |