| NPI | 1942206206 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NC 2019-02814) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: FL ME72544) |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2025-06-02 |