| NPI | 1952409153 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: FL ME124712) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: DC MD038854) |
| 207Y00000X Otolaryngology (Licence: MT 10377) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2019-05-03 |