NPI | 1366415275 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MA 205842) |
Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NH 18281) |
207Y00000X Otolaryngology (Licence: VT 042.0013772) | |
Enumeration Date | 2006-02-10 |
Last Update Date | 2019-04-04 |