| NPI | 1770787343 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: FL ME100127) |
| Additional Taxonomies | 207YX0602X Otolaryngology Otolaryngic Allergy (Licence: FL ME100127) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2013-05-01 |