NPI | 1306004460 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: LA DO.000218) |
Additional Taxonomies | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: OH 34.009560) |
Enumeration Date | 2008-05-27 |
Last Update Date | 2017-04-05 |