NPI | 1154323764 |
---|---|
Entity Type | Individual |
Gender | N/A |
Sole Proprietor ? | No |
Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MA 76188) |
Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NH 9431) |
Enumeration Date | 2005-08-12 |
Last Update Date | 2023-03-07 |