NPI | 1174966188 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: MA 281308) |
Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA A155775) |
Enumeration Date | 2013-04-09 |
Last Update Date | 2024-09-17 |