NPI | 1386734317 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Y00000X Otolaryngology (Licence: DE C10008212) |
Additional Taxonomies | 207Y00000X Otolaryngology (Licence: PA MD061646L) |
207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: DE C10008212) | |
Enumeration Date | 2006-10-13 |
Last Update Date | 2012-01-04 |