NPI | 1609163005 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Y00000X Otolaryngology (Licence: LA 300797) |
Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MS T-2440) |
Enumeration Date | 2011-07-06 |
Last Update Date | 2019-10-30 |