| NPI | 1801954144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NH 19954) |
| Additional Taxonomies | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: FL ME134441) |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2021-01-27 |