| NPI | 1801213954 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MA 283737) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MA ETL6033) |
| 207Y00000X Otolaryngology (Licence: FL ME141041) | |
| Enumeration Date | 2014-03-26 |
| Last Update Date | 2021-03-02 |