| NPI | 1053808931 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: MN 73195) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NY 321271) |
| Enumeration Date | 2018-04-17 |
| Last Update Date | 2024-07-09 |