| NPI | 1801895388 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: FL ME15707) |
| Additional Taxonomies | 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: FL ME15707) |
| Enumeration Date | 2005-07-18 |
| Last Update Date | 2025-09-21 |