| NPI | 1689842429 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: FL ME109361) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: UT 6851462-1205) |
| Enumeration Date | 2008-02-14 |
| Last Update Date | 2020-06-01 |