NPI | 1023218617 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WA MD60564654) |
Additional Taxonomies | 207YP0228X Otolaryngology Pediatric Otolaryngology (Licence: WA MD60564654) |
Enumeration Date | 2007-07-20 |
Last Update Date | 2015-08-17 |