| NPI | 1548286453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA C134084) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NY 272111) |
| 207Y00000X Otolaryngology (Licence: FL ME0081018) | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2020-05-11 |