NPI | 1306832316 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: MA 56662) |
Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MA 56662) |
Enumeration Date | 2005-09-26 |
Last Update Date | 2015-06-22 |