| NPI | 1043256357 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: MN 36117) |
| Additional Taxonomies | 208600000X Surgery (Licence: MN 36117) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2025-06-24 |