NPI | 1316722275 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NY 340006) |
Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MN 34126) |
Enumeration Date | 2023-08-29 |
Last Update Date | 2025-09-22 |