| NPI | 1659332732 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: FL ME59513) |
| Additional Taxonomies | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: FL ME59513) |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2023-07-18 |