NPI | 1255793147 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX T7186) |
Additional Taxonomies | 207Y00000X Otolaryngology (Licence: FL ME149513) |
Enumeration Date | 2016-03-22 |
Last Update Date | 2025-06-13 |