| NPI | 1871581140 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: FL ME84079) |
| Additional Taxonomies | 207YX0602X Otolaryngology Otolaryngic Allergy (Licence: FL ME84079) |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2015-12-30 |