| NPI | 1801902739 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: FL ME92036) |
| Additional Taxonomies | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: FL ME92036) |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2016-11-30 |