| NPI | 1750945663 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: FL ME167873) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: GA 104826) |
| Enumeration Date | 2019-04-25 |
| Last Update Date | 2025-11-21 |