| NPI | 1073667275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: KS 04-24974) |
| Additional Taxonomies | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: MO MD105370) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2020-09-02 |