NPI | 1124477211 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA D7935901) |
Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA A150427) |
Enumeration Date | 2016-06-08 |
Last Update Date | 2022-08-23 |