NPI | 1083616072 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WA MD00029457) |
Additional Taxonomies | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: WA MD00029457) |
207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: WA MD00029457) | |
207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: WA MD00029457) | |
207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: WA MD00029457) | |
Enumeration Date | 2005-08-10 |
Last Update Date | 2015-01-12 |