NPI | 1205148541 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Y00000X Otolaryngology (Licence: UT 10456892-1205) |
Additional Taxonomies | 207Y00000X Otolaryngology (Licence: SC 38365) |
207Y00000X Otolaryngology (Licence: NE 27421) | |
Enumeration Date | 2010-07-01 |
Last Update Date | 2021-06-07 |