NPI | 1093865594 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: CO DR.0060500) |
Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OH 57.022926) |
Enumeration Date | 2007-01-10 |
Last Update Date | 2019-08-12 |