| NPI | 1992877013 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: ME 014725) |
| Additional Taxonomies | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: ME 014725) |
| 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: ME 014725) | |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2009-10-19 |