NPI | 1376532275 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MA 80887) |
Additional Taxonomies | 208200000X Plastic Surgery (Licence: MA 80887) |
231H00000X Audiologist | |
Enumeration Date | 2005-10-14 |
Last Update Date | 2009-01-26 |