NPI | 1245245802 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: MD D61873) |
Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MD D61873) |
Enumeration Date | 2006-07-30 |
Last Update Date | 2025-04-23 |