| NPI | 1891809448 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: FL ME168413) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OH 35.120170) |
| 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: VA 0101241725) | |
| 207YX0901X Otolaryngology, Otology & Neurotology (Licence: OH 35.120170) | |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2024-09-23 |