| NPI | 1992805253 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: ME MD24017) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: VA 0101238624) |
| 207YS0012X (Licence: VA 0101238624) | |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2020-10-08 |