NPI | 1154552651 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NM MD2006-0162) |
Additional Taxonomies | 207Y00000X Otolaryngology (Licence: VT 042-0006468) |
Enumeration Date | 2009-07-31 |
Last Update Date | 2009-07-31 |