NPI | 1366590820 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WA MD60086328) |
Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NY 239514) |
Enumeration Date | 2007-01-08 |
Last Update Date | 2019-11-01 |