NPI | 1073784682 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: CA A120806) |
Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA A120806) |
207Y00000X Otolaryngology (Licence: OH 57.011822) | |
Enumeration Date | 2008-03-22 |
Last Update Date | 2023-02-10 |