| NPI | 1639288749 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: FL ME98569) |
| Additional Taxonomies | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: GA 47569) |
| 207Y00000X Otolaryngology (Licence: GA 47569) | |
| 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: FL ME98569) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2026-10-12 |