| NPI | 1659351872 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: MI 4301074137) |
| Additional Taxonomies | 174400000X Specialist (Licence: MI 4301074137) |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2026-07-15 |