NPI | 1043552508 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA A162321) |
Additional Taxonomies | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: CA A162321) |
Enumeration Date | 2013-03-22 |
Last Update Date | 2019-07-22 |