NPI | 1306229448 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA 141800) |
Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NY 277150) |
Enumeration Date | 2015-07-07 |
Last Update Date | 2017-01-31 |