| NPI | 1700060555 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: FL ME105498) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: GA 056201) |
| Enumeration Date | 2007-12-27 |
| Last Update Date | 2018-03-01 |