NPI | 1043268956 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: PR 9966) |
Additional Taxonomies | 173000000X Legal Medicine (Licence: PR 9966) |
Enumeration Date | 2006-05-04 |
Last Update Date | 2014-05-20 |