| NPI | 1891727418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: FL ME113411) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: AL 19372) |
| 207Y00000X Otolaryngology (Licence: FL ME113411) | |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2019-08-20 |