| NPI | 1821252974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: ME MD19186) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: PA 188377) |
| Enumeration Date | 2008-07-17 |
| Last Update Date | 2012-11-20 |