NPI | 1376049262 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: AZ 71753) |
Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA A164031) |
Enumeration Date | 2018-04-01 |
Last Update Date | 2024-06-30 |