NPI | 1104423680 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: AZ R80723) |
Additional Taxonomies | 207Y00000X Otolaryngology (Licence: ZZ 414909) |
Enumeration Date | 2020-10-07 |
Last Update Date | 2024-06-10 |