| NPI | 1811954712 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NH 8956) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: GA 063305) |
| 207Y00000X Otolaryngology (Licence: NM MD2013-0125) | |
| 207Y00000X Otolaryngology (Licence: ME 011959) | |
| 207Y00000X Otolaryngology (Licence: MA 55754) | |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2019-06-11 |