| NPI | 1093229452 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: MN 72135) | 
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MN 31662) | 
| 207Y00000X Otolaryngology (Licence: MN 72135) | |
| Enumeration Date | 2017-11-21 | 
| Last Update Date | 2025-09-12 |