NPI | 1346244852 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Y00000X Otolaryngology (Licence: LA MD.09174R) |
Additional Taxonomies | 174400000X Specialist (Licence: LA 09174R) |
207Y00000X Otolaryngology (Licence: LA 09174R) | |
Enumeration Date | 2005-06-13 |
Last Update Date | 2024-04-01 |