NPI | 1205853272 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MA 74200) |
Additional Taxonomies | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: MA 74200) |
Enumeration Date | 2006-07-16 |
Last Update Date | 2015-03-02 |