| NPI | 1871760140 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: DC MD039978) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: VA 0116019785) |
| 207Y00000X Otolaryngology (Licence: FL ME112623) | |
| Enumeration Date | 2008-05-14 |
| Last Update Date | 2023-07-31 |