NPI | 1184971194 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: CA A155356) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A155356) |
Enumeration Date | 2012-08-08 |
Last Update Date | 2025-03-12 |