NPI | 1225282882 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: AZ 49273) |
Additional Taxonomies | 207Y00000X Otolaryngology (Licence: AZ 49273) |
Enumeration Date | 2008-11-10 |
Last Update Date | 2016-02-15 |