| NPI | 1538691811 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: PA MD480766) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: FL ME156005) |
| Enumeration Date | 2017-03-28 |
| Last Update Date | 2023-08-23 |