| NPI | 1881611671 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NC 2008-00816) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: FL ME82588) |
| 207Y00000X Otolaryngology (Licence: SC 31310) | |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2021-04-26 |