| NPI | 1982683900 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MN 40897) |
| Additional Taxonomies | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: MN 40897) |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2020-07-10 |