| NPI | 1538130844 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: MN 45555) |
| Additional Taxonomies | 174400000X Specialist (Licence: MN 45555) |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2023-11-07 |