NPI | 1134410038 |
---|---|
Other Name | JON MALLEN-ST. CLAIR |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: CA A125470) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2011-04-26 |
Last Update Date | 2021-01-21 |