| NPI | 1740477447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: FL ME104608) |
| Additional Taxonomies | 207YX0905X Otolaryngology Otolaryngology/Facial Plastic Surgery (Licence: FL ME104608) |
| Enumeration Date | 2007-09-27 |
| Last Update Date | 2019-05-03 |