| NPI | 1639128416 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: FL ME0065243) |
| Additional Taxonomies | 207YP0228X Otolaryngology Pediatric Otolaryngology (Licence: FL ME0065243) |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2020-09-17 |