| NPI | 1992752968 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: ND 12272) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: FL ME39776) |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2012-07-11 |