NPI | 1467751008 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: UT 10478109-1205) |
Additional Taxonomies | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: CA A143092) |
Enumeration Date | 2011-03-22 |
Last Update Date | 2022-07-21 |