| NPI | 1831296748 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: ME MD15457) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NH 11115) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2024-04-12 |