NPI | 1225392558 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MD D85672) |
Additional Taxonomies | 207Y00000X Otolaryngology (Licence: SC 40837) |
207Y00000X Otolaryngology (Licence: PA MT202290) | |
Enumeration Date | 2012-07-02 |
Last Update Date | 2019-03-23 |