| NPI | 1760844427 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: GA 93097) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: FL ME149722) |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2023-01-27 |